Abstract：
OBJECTIVE: Our objective was to investigate trends in the treatment of patients with late-onset rheumatoid arthritis (LORA) using data from the National Database of Rheumatic Diseases in Japan (NinJa).
METHODS: Patients registered in the National Database of Rheumatic Diseases in Japan were classified according to the disease onset: at <65 years (young-onset rheumatoid arthritis); at 65-74 years (early LORA); and at ≥75 years (late LORA). Chronological changes in the treatment and disease activity were compared.
RESULTS: A total of 7178, 13,171, 15,295, and 15,943 patients were evaluated in 2010, 2013, 2016, and 2019, respectively. In all groups, the use of methotrexate gradually decreased, whereas that of biological/targeted synthetic disease-modifying antirheumatic drugs (DMARDs) increased; the use of tumor necrosis factor inhibitors decreased, whereas that of non-tumor necrosis factor inhibitors increased. LORA was characterized by more single DMARD use and less methotrexate and biological/targeted synthetic DMARD use. Tumor necrosis factor inhibitors and interleukin-6 inhibitors were used less frequently, whereas abatacept was utilized more frequently in late versus early LORA. Conventional synthetic DMARD (excluding methotrexate) and glucocorticoid use was higher in late versus early LORA.
CONCLUSIONS: This analysis revealed chronological changes in the treatment of LORA in Japan. Differences between early and late LORA suggest that patients are not a homogeneous population.
METHODS: Patients registered in the National Database of Rheumatic Diseases in Japan were classified according to the disease onset: at <65 years (young-onset rheumatoid arthritis); at 65-74 years (early LORA); and at ≥75 years (late LORA). Chronological changes in the treatment and disease activity were compared.
RESULTS: A total of 7178, 13,171, 15,295, and 15,943 patients were evaluated in 2010, 2013, 2016, and 2019, respectively. In all groups, the use of methotrexate gradually decreased, whereas that of biological/targeted synthetic disease-modifying antirheumatic drugs (DMARDs) increased; the use of tumor necrosis factor inhibitors decreased, whereas that of non-tumor necrosis factor inhibitors increased. LORA was characterized by more single DMARD use and less methotrexate and biological/targeted synthetic DMARD use. Tumor necrosis factor inhibitors and interleukin-6 inhibitors were used less frequently, whereas abatacept was utilized more frequently in late versus early LORA. Conventional synthetic DMARD (excluding methotrexate) and glucocorticoid use was higher in late versus early LORA.
CONCLUSIONS: This analysis revealed chronological changes in the treatment of LORA in Japan. Differences between early and late LORA suggest that patients are not a homogeneous population.
摘要：
目的：使用日本国家风湿病数据库（NinJa）的数据，调查晚发性类风湿关节炎（LORA）患者的治疗趋势。
方法：在NinJa注册的患者根据疾病发作进行分类：<65岁（青年型类风湿关节炎[YORA]）；65-74岁（早期LORA）；≥75岁（晚期LORA）。比较了治疗和疾病活动的时间变化。
结果：在2010年、2013年、2016年和2019年分别评估了7,178、13,171、15,295和15,943名患者。在所有组中,甲氨蝶呤的使用逐渐减少，而生物/靶向合成抗风湿药（DMARDs）的增加;肿瘤坏死因子抑制剂（TNFi）的使用减少，而非TNFi的增加。LORA的特点是使用更多的单一DMARD，和较少的甲氨蝶呤和生物/靶向合成DMARD使用。TNFi和白介素-6抑制剂的使用频率较低，而abatacept在晚期与早期LORA中使用频率更高。晚期与早期LORA相比，常规合成DMARD（不包括甲氨蝶呤）和糖皮质激素的使用更高。
结论：该分析揭示了日本LORA治疗的时间变化。早期和晚期LORA之间的差异表明患者不是同质人群。
方法：在NinJa注册的患者根据疾病发作进行分类：<65岁（青年型类风湿关节炎[YORA]）；65-74岁（早期LORA）；≥75岁（晚期LORA）。比较了治疗和疾病活动的时间变化。
结果：在2010年、2013年、2016年和2019年分别评估了7,178、13,171、15,295和15,943名患者。在所有组中,甲氨蝶呤的使用逐渐减少，而生物/靶向合成抗风湿药（DMARDs）的增加;肿瘤坏死因子抑制剂（TNFi）的使用减少，而非TNFi的增加。LORA的特点是使用更多的单一DMARD，和较少的甲氨蝶呤和生物/靶向合成DMARD使用。TNFi和白介素-6抑制剂的使用频率较低，而abatacept在晚期与早期LORA中使用频率更高。晚期与早期LORA相比，常规合成DMARD（不包括甲氨蝶呤）和糖皮质激素的使用更高。
结论：该分析揭示了日本LORA治疗的时间变化。早期和晚期LORA之间的差异表明患者不是同质人群。
